https://doi.org/10.4081/aiua.2020.4.345
Which factors affect the success of pediatric PCNL? Single center experience over 20 years
Submitted: May 24, 2020
Accepted: July 30, 2020
Published: December 18, 2020
Accepted: July 30, 2020
Abstract Views: 957
PDF: 481
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Objective: We aimed to investigate the impact of surgeons’ experience on pediatric percutaneous nephrolithotomy (PCNL) outcomes. Materials and methods: Between June 1997 and June 2018, 573 pediatric patients with 654 renal units underwent PCNL for renal stone disease by senior surgeons. Data were divided into two groups, group-1 (n = 267), first ten years period, group-2 (n = 387); second ten years period. Results: Mean ± SD age of patients was 7.6 ± 4.9 (1-17) years. The stone-free rates (SFR) assessed after 4 weeks were 74.9% vs. 83.4% in group-1 vs. group-2, respectively (p = 0.03). The mean operation time, fluoroscopy time, and the number of patients requiring blood transfusion significantly decreased in group 2 (100.4 ± 57.5 vs. 63.63 ± 36.3, 12.1 ± 8.3 vs. 8.3 ± 5.4, and 24.3% vs. 2.9%; p < 0.001, p < 0.001, and p = 0.002 in group-1 versus group-2, respectively). On multivariate analysis, increasing stone size increased operation time (p < 0.001), fluoroscopy time (p < 0.001), intraoperative and postoperative blood transfusion rates (p = 0.006 and p = 0.018, respectively), and hospital stay (p = 0.002) but was not associated with change of glomerular filtration rate (GFR) (p = 0.71). Sheath size also correlated with increased fluoroscopy time (p < 0.001), operation time (p < 0.001), intraoperative blood transfusion (p < 0.001) and hospital stay, but sheath size did not affect postoperative blood transfusion (p = 0.614) or GFR change (p = 0.994). Conclusions: The percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure and is well accepted because of its lower complication rate and high efficiency for pediatric patients. Stone and sheath size are predictive factors for blood loss and hospital stay. During 20 years, our fluoroscopy time, operation time, blood loss, and complication rates decreased, and stone-free rate increased.
Bartosh SM. Medical management of paediatric stone disease. Urol Clin North Am 2004; 31: 575–87
DOI: https://doi.org/10.1016/j.ucl.2004.04.005
Türk C, Neisius A, Petřík A, Seitz C, Skolarikos A, Thomas K. EAU Guidelines on interventional treatment for urolithiasis. EAU Guidelines. Edn. presented at the EAU Annual Congress London 2018. ISBN 978-94-92671-01-1.
Matlaga BR, Kim SC, Lingeman JE. Improving outcomes of percutaneous nephrolithotomy: access. Eur Urol. EAU Update Ser 2005; 3: 37-43.
DOI: https://doi.org/10.1016/j.euus.2004.11.002
Woodside JR, Stevens GF, Stark GL, Borden TA, Ball WS. Percutaneous stone removal in children. J Urol 1985; 134:1166–7.
DOI: https://doi.org/10.1016/S0022-5347(17)47669-5
Guven S, Istanbulluoglu O, Gul U, et al. Successful percutaneous nephrolithotomy in children: multicentre study on current status of its use, efficacy and complications using Clavien classification. J Urol 2011; 185:1419–24
DOI: https://doi.org/10.1016/j.juro.2010.11.055
Unsal A, Resorlu B, Kara C, Bozkurt OF, Ozyuvali E. Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 2010; 76:247-52
DOI: https://doi.org/10.1016/j.urology.2009.08.087
Guven S, Farttini A, Onal B, et al. Behalf of the CROES PCNL Study Group. Percutaneous nephrolithotomy in children in different age groups: data from the Clinical Research Office of the Endourological Society (CROES) Percutaneous Nephrolithotomy Global Study. BJU International 2012; 111:148–56.
DOI: https://doi.org/10.1111/j.1464-410X.2012.11239.x
Zeren S, Satar N, Bayazit Y, Bayazit AK, Payasli K, Ozkeçeli R. Percutaneous nephrolithotomy in the management of pediatric renal calculi. J Endourol 2002; 16:75-8.
DOI: https://doi.org/10.1089/089277902753619546
Desai M. Endoscopic management of stones in children. Curr Opin Urol 2005; 15(2):107-12.
DOI: https://doi.org/10.1097/01.mou.0000160625.59107.fd
Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16(1):31–41.
DOI: https://doi.org/10.1159/000180580
Dindo D, Demartines N, Clavien PA. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240:205-13.
DOI: https://doi.org/10.1097/01.sla.0000133083.54934.ae
Cıtamak B, Altan M, Bozacı AC, et al. Percutaneous Nephrolithotomy in Children: 17 Years of Experience. J Urol 2016; 195(4Pt1):1082-7.
DOI: https://doi.org/10.1016/j.juro.2015.11.070
Yadav P, Madhavan K, Syal S, Farooq A, Srivastava A, Ansari MS. Technique, complications, and outcomes of pediatric urolithiasis management at a tertiary care hospital: evolving paradigms over the last 15 years. J Pediatr Urol 2019 Sep 17; pii: S1477-5131(19):30297-9.
Goyal NK, Goel A, Sankhwar SN, et al. A critical appraisal of complications of percutaneous nephrolithotomy in paediatric patients using adult instruments. BJU Int 2014; 113(5):801-10.
DOI: https://doi.org/10.1111/bju.12506
Smaldone MC, Docimo SG, Ost MC. Contemporary surgical management of paediatric urolithiasis. Urol Clin North Am 2010; 37(2):253–67.
DOI: https://doi.org/10.1016/j.ucl.2010.03.006
Bilen CY, Kocak G, Kitirci O, Ozkaya O, Sarikaya S. Percutaneous nephrolithotomy in children: lessons learned in 5 years at a single institution. J Urol 2007; 177(5):1867-71.
DOI: https://doi.org/10.1016/j.juro.2007.01.052
Jones P, Bennett G, Aboumarzouk OM, Griffin S, Somani BK. Role of Minimally Invasive Percutaneous Nephrolithotomy Techniques-Micro and Ultra-Mini PCNL (<15F) in the Pediatric Population: A Systematic Review. J Endourol 2017; 31(9):816-24.
DOI: https://doi.org/10.1089/end.2017.0136
Ozden E, Mercimek MN, Yakupoglu YK, Ozkaya O, Sarikaya S. Modified Clavien classification in percutaneous nephrolithotomy: assessment of complications in children. J Urol 2011; 185(1):264-8 .
DOI: https://doi.org/10.1016/j.juro.2010.09.023
Mishra S, Sharma R, Garg C, Kurien A, Sabnis R, Desai M. Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int 2011; 108(6):896–9.
DOI: https://doi.org/10.1111/j.1464-410X.2010.09936.x
Karatag T, Tepeler A, Sılay MS, et al. Comparison of 2 percutaneous nephrolitotomy technique for the treatment of pediatric kidney stones of sized 10-20 mm: Microperc vs Miniperc. Urology 2015; 85:015-8
DOI: https://doi.org/10.1016/j.urology.2015.02.010
Onal B, Dogan HS, Satar N, et al. Factors affecting complication rates of percutaneous nephrolithotomy in children: results of a multi-institutional retrospective analysis by the Turkish pediatric urology society. J Urol 2014; 191(3):777-82.
DOI: https://doi.org/10.1016/j.juro.2013.09.061
Altintas R, Oguz F, Tasdemir C, et al. The importance of instrument type in paediatric percutaneous nephrolithotomy. Urolithiasis 2014; 42(2):149–53.
DOI: https://doi.org/10.1007/s00240-013-0626-z
Traxer O, Smith 3rd TG, Pearle MS, Corwin TS, Saboorian H, Cadeddu JA. Renal parenchymal injury after standard and mini percutaneous nephrostolithotomy. J Urol 2001; 165(5):1693-5.
DOI: https://doi.org/10.1016/S0022-5347(05)66395-1
Bayrak O, Erturhan S, Seckiner I, et al. Reliability of percutaneous nephrolithotomy in pediatric patients: comparison of complications with those in adults. Korean J Urol 2013; 54(6):383-7.
DOI: https://doi.org/10.4111/kju.2013.54.6.383
Celik H, Camtosun A, Dede O, Dagguli M, Altintas R, Tasdemir C. Comparison of the results of pediatric percutaneous nephrolithotomy with different sized instruments. Urolithiasis 2017; 45(2):203–8.
DOI: https://doi.org/10.1007/s00240-016-0887-4
How to Cite
Izol, V., Satar, N., Bayazit , Y., Gokalp, F., Akdogan, N., & Aridogan, I. A. (2020). Which factors affect the success of pediatric PCNL? Single center experience over 20 years. Archivio Italiano Di Urologia E Andrologia, 92(4). https://doi.org/10.4081/aiua.2020.4.345
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Mehdi Shirazi, Umayir Chowdhury, Faisal Ahmed, Mohammad-Bagher Rajabalian, Hossein-Ali Nikbakht , Khalil Al-Naggar , Ebrahim Al-Shami , Optimal clamping time in meatotomy procedure for children with meatal stenosis: Experience with 120 cases , Archivio Italiano di Urologia e Andrologia: Vol. 93 No. 2 (2021)
- Ali Eslahi, Faisal Ahmed, Mohammad Mehdi Hosseini , Mohammad Reza Rezaeimehr, Nazanin Fathi, Hossein-Ali Nikbakht , Mohammad Reza Askarpour, Seyed Hossein Hosseini , Khalil Al-Naggar, Minimal invasive percutaneous nephrolithotomy (Mini-PCNL) in children: Ultrasound versus fluoroscopic guidance , Archivio Italiano di Urologia e Andrologia: Vol. 93 No. 2 (2021)
- Ali Eslahi, Faisal Ahmed, Mohammad Rahimi, Seyed Hamed Jafari, Seyyed Hossein Hosseini, Saleh Al-wageeh, Pegah Mohammad Zadeh Shirazi, Khalil Al-naggar, Ebrahim Al-shami , Mohammad Hossein Taghrir, Outcome of Transperitoneal Laparoscopic Ureterolithotomy (TPLU) for proximal ureteral stone > 15 mm: Our experience with 60 cases , Archivio Italiano di Urologia e Andrologia: Vol. 93 No. 3 (2021)
- Saif Ghabisha, Faisal Ahmed, Saleh Al-wageeh, Mohamed Badheeb, Qasem Alyhari, Abdulfattah Altam, Afaf Alsharif, Prognostic determinants and treatment outcomes of Fournier’s Gangrene treatment in a resource-limited setting: A retrospective study , Archivio Italiano di Urologia e Andrologia: Vol. 95 No. 3 (2023)
- Faisal Ahmed, Hossein-Ali Nikbakht, Khalil Al-Naggar, Saleh Al-Wageeh, Qasem Alyhari, Saif Ghabisha, Ebrahim Al-Shami, Menawar Dajenah, Waleed Aljbri, Fawaz Mohammed, Abdu Al-Hajri, Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study , Archivio Italiano di Urologia e Andrologia: Vol. 94 No. 2 (2022)
- Khaled Al-Kohlany, Khaled Baker, Faisal Ahmed, Murtadha Mohamed, Majdi Alshami, Mohamed Badheeb, Treatment outcome of Fournier's gangrene and its associated factors: A retrospective study , Archivio Italiano di Urologia e Andrologia: Vol. 95 No. 2 (2023)
You may also start an advanced similarity search for this article.